Challenges and trends in Gram-negative bacterial infections in critically neonates: A seven-and-a-half-year observational study.

BACKGROUND: Analyze the incidence, risk factors, and fatality rates of bloodstream infections by Gram-negative bacteria (GNB-BSIs) in a Neonatal Intensive Care Unit. METHODS: This study employs a retrospective cohort design utilizing records of neonates admitted to the Neonatal Intensive Care Unit between January 2015 and June 2022. RESULTS: Among 1,495 neonates, 5.2% developed GNB-BSIs. The average incidence of infection per 1,000 patient-days was 2.9. Primary risk factors for infection that included preceeding carbapenem use were significant risk factors (odds ratio=514.4; P < .01) and fourth-generation cephalosporins (odds ratio=66; P < .01). Among the 85 GNB, 75.3% were fermenters, and 24.7% were non-fermenters. Of the isolates, 14.1% produced extended-spectrum beta-lactamase, and 2.3% carbapenem-resistant. Infection correlated with prolonged hospital stays (10-39days) and increased mortality (10%-29.9%). CONCLUSIONS: The high incidence of GNB-BSIs was exacerbated by the preceeding use of broad-spectrum antimicrobials, increasing the presence of multidrug-resistant isolates and fatality rates. These findings emphasize the importance of active surveillance.

Calidad higiénico-sanitaria y prácticas de manufactura de alimentos en un comedor estudiantil en México / Hygienic ­ sanitary quality and food manufacturing practices in a student cafeteria in Mexico / Qualidade higiênico-sanitária e práticas de fabricação de alimentos em uma refeitório estudantil no México

Introducción: El apego a las normas oficiales sanitarias sirve para prevenir riesgos a la salud humana. Objetivo: Evaluar la calidad higiénico-sanitaria y las buenas prácticas de manufactura de alimentos (BPMA) de un comedor estudiantil en México. Materiales y métodos: Estudio cuasiexperimental y analítico. Durante el año 2020, se realizaron pruebas bacteriológicas a muestras de alimentos, agua, superficies y manos de manipuladores de alimentos, además de también evaluar las BPMA. Conforme a las normas oficiales sanitarias vigentes en México, se recolectaron 57 muestras, se aislaron y se lograron identificar patógenos. Las BPMA se valoraron en 20 manipuladores, antes y después de una intervención educativa de 10 semanas de duración y se utilizó la prueba t con α=0,05. Resultados: Más del 50 % de las muestras resultaron con microorganismos de riesgo para la salud, como Escherichia coli, Staphylococcus aureus, Pseudomonas, Acinetobacter baumanni complex y Coliformes totales. Las evaluaciones, antes y después de la intervención educativa de BPMA, evidenciaron diferencias estadísticamente significativas en el número de aciertos (p≤0,05). Conclusiones: La calidad higiénico-sanitaria del comedor analizado representó riesgo para la salud de los estudiantes, lo cual tuvo relación con la primera evaluación de las BPMA entre los manipuladores, las cuales mejoraron después de la intervención.

Introduction: Adherence to official health standards is essential to prevent human health risks. Objective: To assess the hygienic-sanitary quality and good food manufacturing practices (GMP) in a student cafeteria in Mexico. Materials and methods: Quasi-experimental and analytical study. During 2020, bacteriological tests were carried out on samples taken from food, water, surfaces, and hands of food handlers. In addition, GMP were evaluated. Based on the current Mexican official health regulations, 57 samples were collected to isolate and identify pathogens. GMP were assessed in 20 food handlers before and after a 10-week training intervention and a test was used with α=0.05. Results: More than 50% of samples were found to have microorganisms associated with health risks, including Escherichia coli, Staphylococcus aureus, Pseudomonas, Acinetobacter baumanni complex and total Coliforms. The analyses before and after the GMP training intervention showed statistically significant differences in terms of the presence of these pathogens (p≤0.05). Conclusions: The hygienic-sanitary quality of the analyzed cafeteria turned out to be a risk for the health of students, which was related to the first assessment of GMP in food handlers. Consequently, the results improved after the intervention.

Introdução: A adesão às normas sanitárias oficiais serve para prevenir riscos à saúde humana. Objetivo: Avaliar a qualidade higiênico-sanitária e as boas práticas de fabricação de alimentos (BPMA) de um refeitorio estudantil no México. Materiais e métodos: Estudo quase-experimental e analítico. Durante 2020, foram realizados testes bacteriológicos em amostras de alimentos, água, superfícies e mãos de manipuladores de alimentos, além de avaliação de BPMA. De acordo com as normas sanitárias oficiais em vigor no México, foram coletadas e isoladas 57 amostras e identificados patógenos. Os BPMA foram avaliados em 20 manipuladores, antes e após uma intervenção educativa de 10 semanas e foi utilizado o teste t com α=0,05. Resultados: Verificou-se que mais de 50% das amostras continham microrganismos de risco à saúde, como Escherichia coli, Staphylococcus aureus, Pseudomonas, complexo Acinetobacter baumanni e Coliformes totais. As avaliações, antes e após a intervenção educativa BPMA, apresentaram diferenças estatisticamente significativas no número de acertos (p≤0,05). Conclusões: A qualidade higiênico-sanitária do refeitório analisado representou um risco para a saúde dos alunos, o que esteve relacionado à primeira avaliação do BPMA entre os manipuladores, que melhorou após a intervenção.

Identificación de enterobacterias productoras de carbapenemasas en el Hospital Universitario Católico de Cuenca / Identification of carbapenemase producing enterobacteriaceae at the Catholic University Hospital of Cuenca / Identificação de enterobacteriaceae produtoras de carbapenemase no Hospital Universitário Católico de Cuenca

Las enterobacterias productoras de carbapenemasas desarrollan infecciones resistentes a los medicamentos en neumonía, infección del tracto urinario e infecciones relacionadas con dispositivos. Klebsiella pneumoniae, Escherichia coli y Enterobacter cloacae son amenazas de resistencia emergentes importantes a nivel mundial, lo que representa alta mortalidad y limitadas opciones de tratamiento. Objetivo: detectar la presencia de EPC de clase A, mediante la aplicación del test fenotípico de sinergia con ácido borónico en cepas de enterobacterias aisladas de superficies inertes en el Hospital Universitario Católico de Cuenca, Ecuador. Materiales y Métodos: estudio cuali-cuantitativo de tipo experimento puro de corte transversal y alcance exploratorio - descriptivo. Las enterobacterias se identificaron mediante test bioquímicos del sistema estandarizado API 20 E. Para la detección fenotípica de carbapenamasas de clase A se utilizó el método de sinergia de discos con ácido borónico y discos imipenem, meropenem y ertapenem. Resultados: se identificaron 25 géneros de enterobacterias, el 24 % fue Pseudomonas aeruginosam, el 20 % de enterobacterias fue productoras de carpapenemasas clase Am mientras que el 32 % fue resistente para los tres carbapenémicos en estudio, el 68 % mostró sensibilidad para imipenem, el 56 % para meropenem y 44 % para ertapenem. El 48 % de enterobacterias fueron resistentes a ertapenem, el 44 % a meropenem y 32 % a imipenem. Conclusiones: Enterobacterias como P. aureginosa, E. cloacae, Cronobacter spp. y E. coli presentan mecanismos de resistencia asociados a carbapenemasas clase A tipo KPC por lo que se recomienda vigilancia continua y estrategias de manejo para abordar la resistencia a carbapenémicos en entornos hospitalarios

Carbapenemase-producing Enterobacteriaceae develop drug-resistant infections in pneumonia, urinary tract infection, and device-related infections. Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae are important emerging resistance threats globally, representing high mortality and limited treatment options. Objective: detect the presence of class A EPC, by applying the phenotypic synergy test with boronic acid in strains of enterobacteria isolated from inert surfaces at the Catholic University Hospital of Cuenca, Ecuador. Materials and Methods: Qualitative-quantitative study of pure cross-sectional experiment type and exploratorydescriptive scope. Enterobacteriaceae were identified using biochemical tests of the standardized API 20 E system. For the phenotypic detection of class A carbapenamases, the synergy method of disks with boronic acid and imipenem, meropenem and ertapenem disks was used. Results: 25 genera of enterobacteria were identified, 24 % were Pseudomonas aeruginosam, 20 % of enterobacteria were producers of class Am carbapenemases while 32 % were resistant to the three carbapenems under study, 68 % showed sensitivity to imipenem, 56 % for meropenem and 44 % for ertapenem. 48 % of enterobacteria were resistant to ertapenem, 44 % to meropenem and 32 % to imipenem. Conclusions: Enterobacteriaceae such as P. aureginosa, E. cloacae, Cronobacter spp. and E. coli present resistance mechanisms associated with class A carbapenemases type KPC, so continuous surveillance and management strategies are recommended to address resistance to carbapenems in hospital environments

Enterobacteriaceae produtoras de carbapenemases desenvolvem infecções resistentes a medicamentos em pneumonia, infecção do trato urinário e infecções relacionadas a dispositivos. Klebsiella pneumoniae, Escherichia coli e Enterobacter cloacae são importantes ameaças emergentes de resistência em todo o mundo, representando alta mortalidade e opções de tratamento limitadas. Objetivo: detectar a presença de CPE classe A, aplicando o teste de sinergia fenotípica com ácido borônico em cepas de enterobactérias isoladas de superfícies inertes no Hospital Universitário Católico de Cuenca, Equador. Materiais e Métodos: estudo cualitativo quantitativo, do tipo experimento transversal puro e escopo exploratório-descritivo. As enterobactérias foram identificadas por meio de testes bioquímicos do sistema padronizado API 20 E. Para a detecção fenotípica das carbapenamases classe A foi utilizado o método de sinergia de discos com ácido borônico e discos de imipenem, meropenem e ertapenem. Resultados: foram identificados 25 gêneros de enterobactérias, 24 % eram Pseudomonas aeruginosam, 20 % das enterobactérias eram produtoras de carbapenemases da classe Am enquanto 32 % eram resistentes aos três carbapenêmicos em estudo, 68 % apresentaram sensibilidade ao imipenem, 56 % ao meropenem e 44. % para ertapenem. 48 % das enterobactérias eram resistentes ao ertapenem, 44 % ao meropenem e 32 % ao imipenem. Conclusões: Enterobacteriaceae como P. aureginosa, E. cloacae, Cronobacter spp. e. coli apresentam mecanismos de resistência associados às carbapenemases classe A tipo KPC, portanto estratégias contínuas de vigilância e manejo são recomendadas para abordar a resistência aos carbapenêmicos em ambientes hospitalares.

Preliminary snapshot reveals a relationship between multidrug-resistance and biofilm production among enterobacteriaceae isolated from fecal samples of farm-raised poultry in ceará, Brazil.

Antimicrobial resistance and biofilm formation by microbial pathogens pose a significant challenge to poultry production systems due to the persistent risk of dissemination and compromise of bird health and productivity. In this context, the study aimed to investigate the occurrence of different multiresistance phenotypes and the biofilm-forming ability of Enterobacteriaceae isolated from broiler chicken excreta in poultry production units in Ceará, Brazil. Samples were collected from three distinct broiler breeding facilities and subjected to isolation, identification, antibiotic susceptibility testing, phenotypic screening for ß-lactamases enzymes, and biofilm formation evaluation. Seventy-one strains were identified, being Escherichia coli (37 %) and Proteus mirabilis (32 %), followed by Klebsiella pneumoniae (11 %), Providencia stuartii (9 %), Klebsiella aerogenes (6 %), Alcaligenes faecalis (4 %), and Salmonella sp. (1 %). A significant proportion (87 %) of multiresistant strains were detected. For the phenotypic evaluation of ß-lactamases production, strains with resistance to second and third-generation cephalosporins and carbapenems were tested. About 4 of 6 and 10 of 26 were positive for inducible chromosomal AmpC ß-lactamase and extended-spectrum ß-lactamase (ESBL), respectively. Regarding biofilm formation, it was observed that all MDR strains were capable of forming biofilm. In this sense the potential of these MDR bacteria to develop biofilms becomes a significant concern, representing a real threat to both human and animal health, as biofilms offer stability, antimicrobial protection, and facilitate genetic transfer.

Ceftazidime and Usnic Acid Encapsulated in Chitosan-Coated Liposomes for Oral Administration against Colorectal Cancer-Inducing Escherichia coli.

Escherichia coli has been associated with the induction of colorectal cancer (CRC). Thus, combined therapy incorporating usnic acid (UA) and antibiotics such as ceftazidime (CAZ), co-encapsulated in liposomes, could be an alternative. Coating the liposomes with chitosan (Chi) could facilitate the oral administration of this nanocarrier. Liposomes were prepared using the lipid film hydration method, followed by sonication and chitosan coating via the drip technique. Characterization included particle size, polydispersity index, zeta potential, pH, encapsulation efficiency, and physicochemical analyses. The minimum inhibitory concentration and minimum bactericidal concentration were determined against E. coli ATCC 25922, NCTC 13846, and H10407 using the microdilution method. Antibiofilm assays were conducted using the crystal violet method. The liposomes exhibited sizes ranging from 116.5 ± 5.3 to 240.3 ± 3.5 nm and zeta potentials between +16.4 ± 0.6 and +28 ± 0.8 mV. The encapsulation efficiencies were 51.5 ± 0.2% for CAZ and 99.94 ± 0.1% for UA. Lipo-CAZ-Chi and Lipo-UA-Chi exhibited antibacterial activity, inhibited biofilm formation, and preformed biofilms of E. coli. The Lipo-CAZ-UA-Chi and Lipo-CAZ-Chi + Lipo-UA-Chi formulations showed enhanced activities, potentially due to co-encapsulation or combination effects. These findings suggest potential for in vivo oral administration in future antibacterial and antibiofilm therapies against CRC-inducing bacteria.

W-GA nanodots restore intestinal barrier functions by regulating flora disturbance and relieving excessive oxidative stress to alleviate colitis.

Inflammatory bowel disease (IBD) may arise due to disruption of mucosal barriers as a result of dysregulation of the intestinal flora and excessive oxidative stress. The creation of nanomaterials with only microbiota-regulating effects often leads to inadequate therapeutic outcomes caused by the disruption of a healthy microbial balance and the emergence of tissue harm caused by excessive oxidative stress. This report describes the multifunctional activity of ultrasmall W-GA nanodots, which can precisely regulate the intestinal microbiome by inhibiting the abnormal expansion of Enterobacteriaceae during colitis and alleviating the damage caused by oxidative stress to the reconstructive microflora, ultimately restoring intestinal barrier function. W-GA nanodots have been synthesized through a simple coordination reaction and can be dispersed in various solvents in vitro, demonstrating favorable safety profiles in cells, significant clearance of reactive oxygen and nitrogen species (RONS), and increased cell survival in models of oxidative stress induced by hydrogen peroxide (H2O2). Through oral or intravenous administration, the W-GA nanodots were shown to be highly safe when tested in vivo, and they effectively reduced colon damage in mice with DSS-induced colitis by restoring the integrity of the intestinal barrier. W-GA nanodots have enabled the integration of microflora reprogramming and RONS clearance, creating a potent therapeutic strategy for treating gut inflammation. Consequently, the development of W-GA nanodots represents a promising strategy for enhancing the formation and preservation of the intestinal barrier to treat IBD by suppressing the growth of Enterobacteriaceae, a type of facultative anaerobic bacterium, and facilitating the effective removal of RONS. Ultimately, this leads to the restoration of the intestinal barrier's functionality. STATEMENT OF SIGNIFICANCE: An increasing number of nanoparticles are under development for treating inflammatory bowel disease. Although they can alleviate inflammation symptoms by regulating reactive oxygen and nitrogen species (RONS) and microbiota, their understanding of the mechanism behind microbiota regulation is limited. This study synthesized W-GA nanodots using a straightforward one-pot synthesis method. Simple synthesis holds significant promise for clinical applications, as it encompasses multiple nanoenzyme functions and also exhibits Enterobacteriaceae inhibitory properties.Thus, it contributes to ameliorating the current medical landscape of inflammatory bowel disease.

Prevalence, antimicrobial resistance and detection of virulence genes of Escherichia coli and Salmonella spp. isolated from white-lipped peccaries and collared peccaries.

Salmonella spp. and Escherichia coli are implicated in human and animal infections and require antimicrobial treatment in many situations. Faecal samples of healthy white-lipped peccaries (Pecari tajacu) (n = 30) and collared peccaries (Tayassu pecari ) (n = 60) obtained in three farms located in the Midwest Brazil. The antimicrobial profiles of commensal E. coli from P. tajacu and T. pecari from commercial herds in Brazil were isolated and analyzed and virulence genes were detected. Among 90 healthy animals, no Salmonella spp. were isolated. However, 30 samples (27%) tested positive for E. coli, with 18 isolates from P. tajacu and 12 from T. pecari, representing frequencies of 58.0% and 38.7%, respectively. Additionally, other Enterobacteriaceae family bacteria were detected but not included in this analysis. However, individual samples from 30 animals tested positive for E. coli, of which 16 were isolated from P. tajacu presenting multidrug resistance and six were isolated from T. pecari presenting a similar pattern. The E. coli virulence genes detected were papC (pilus-associated pyelonephritis) in five isolates, tsh (temperature-sensitive hemagglutinin) in one isolate, and eae (enteric attachment and effacement) in one isolate. The serum resistance gene, iss (increased serum survival), was detected in four isolates. An association between these genes and the presence of hemolysin was also observed in one isolate. Thus, T. pecari and P. tajacu are potential reservoirs of pathogenic and multidrug-resistant and E. coli. Faecal E. coli of healthy P. tajacu and T. pecari could act as a possible reservoir of antimicrobial resistance genes in environment.

Identificação de Enterococcus SPP e Enterobacteriaceae em canais radiculares com infecção primária e secundária ou persistente / Identification of Enterococcus spp and Enterobacteriaceae in root canals with primary and secondary or persistent infection

O objetivo do presente estudo foi identificar microrganismos das espécies Enterococcus spp e Enterobacteriaceae em dentes com canais radiculares infectados portadores de infecção primária e/ou secundária/persistente. Métodos: A amostra do presente estudo foi de 23 pacientes que apresentaram necessidade de tratamento ou retratamento endodôntico. Foram coletadas amostras de 28 dentes infectados usando pontas de papel absorventes estéreis, transportadas em solução salina, diluídas, plaqueadas e incubadas em estufa de cultura bacteriológica. Para o crescimento de microrganismos foram utilizados jarros com gerador de atmosfera de anaerobiose. Colônias microbianas foram isoladas, caracterizadas e identificadas. Os dados coletados foram estatisticamente analisados com a utilização do software SPSS for Windows 10.0 (SPSS Inc., USA). Resultados: Foi isolada somente uma cepa do gênero Enterococcus spp, e nenhuma espécie do gênero Enterobacteriaceae. Das coletas microbiológicas realizadas em 28 canais radiculares, todas apresentaram crescimento microbiano em anaerobiose. Dezoito dentes apresentavam necrose pulpar e lesão periapical. Os outros 10 dentes já haviam recebido tratamento endodôntico prévio e em 6 destes houve constatação de lesão periapical, sendo que nos outros 4, não. Conclusão: Nas condições experimentais do presente estudo, pode-se concluir que não houve correlação da presença de espécies microbianas das famílias Enterococcus spp e/ou Enterobacteriaceae com infecção primária ou secundária do canal radicular.

The objective of the present study was to identify microorganisms of the Enterococcus spp and Enterobacteriaceae species in teeth with infected root canals with primary and/or secondary/persistent infection. Methods: The sample of the present study consisted of 23 patients who required endodontic treatment or retreatment. Samples of 28 infected teeth were collected using sterile absorbent paper points, transported in saline solution, diluted, plated and incubated in a bacteriological culture oven. For the growth of microorganisms, jars with an anaerobic atmosphere generator were used. Microbial colonies were isolated, characterized and identified. The collected data were statistically analyzed using the SPSS for Windows 10.0 software (SPSS Inc., USA). Results: Only one strain of the genus Enterococcus spp was isolated, and no species of the genus Enterobacteriaceae. From the microbiological collections carried out in 28 root canals, all showed microbial growth in anaerobic conditions. Eighteen teeth had pulp necrosis and periapical lesion. The other 10 teeth had already received previous endodontic treatment and in 6 of them there was a periapical lesion, and in the other 4, no. Conclusion: Under the experimental conditions of the present study, it can be concluded that there was no correlation between the presence of microbial species of the Enterococcus spp and/or Enterobacteriaceae families with primary or secondary root canal infection.

Antimicrobial resistance of Enterobacteriaceae and Staphylococcus spp. isolated from raw cow's milk from healthy, clinical and subclinical mastitis udders.

Mastitis is the most common disease of dairy cattle and can be manifested in clinical and subclinical forms. The overuse of antimicrobials in the treatment and prevention of mastitis favours antimicrobial resistance and milk can be a potential route of dissemination. This study aimed to evaluate the biological quality of bulk tank milk (BTM) and the microbiological quality and signs of mastitis of freshly milked raw milk. In addition, to evaluate antimicrobial resistance in Enterobacteriaceae and Staphylococcus spp. isolated from freshly milked raw milk. None of the farms were within the official Brazilian biological quality limits for BTM. Freshly milked raw milk with signs of clinical (CMM), subclinical (SCMM) and no signs (MFM) of mastitis were detected in 6.67%, 27.62% and 65.71% samples, respectively. Most samples of freshly milked raw milk showed acceptable microbiological quality, when evaluating the indicators total coliforms (78.10%), Escherichia coli (88.57%) and Staphylococcus aureus (100%). Klebsiella oxytoca and S. aureus were the most prevalent microorganisms in SCMM and MFM samples. Antimicrobial resistance and multidrug resistance (MDR) were observed in 65.12% and 13.95% of Enterobacteriaceae and 84.31% and 5.88% of Staphylococcus spp., respectively, isolated from both SCMM and MFM samples. Enterobacteriaceae resistant to third-generation cephalosporin (3GCR) (6.98%) and carbapenems (CRE) (6.98%) and methicillin-resistant S. aureus (MRSA) (4.88%) were observed. Antimicrobial-resistant bacteria can spread resistance genes to previously susceptible bacteria. This is a problem that affects animal, human and environmental health and should be evaluated within the one-health concept.

Resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario en pacientes ambulatorios / Antimicrobial resistance of Enterobacteriaceae causing urinary tract infection in ambulatory patients / Resistência antimicrobiana de Enterobacteriaceae causadora de infecção do trato urinário em pacientes ambulatoriais

Las infecciones del tracto urinario son consideradas un problema de salud a nivel hospitalario y comunitario por el aumento de bacterias resistentes a los antibióticos. Objetivo: Analizar el patrón de susceptibilidad y resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario. Métodos: Se aplicó una investigación descriptiva de diseño documental. La población fue de 672 registros de urocultivos positivos, recopilados de la base de datos del Laboratorio San Pablo en el periodo 2021-2022. Para su tabulación y análisis los datos obtenidos fueron procesados en el Software SPSS versión 25.0. Resultados: Las ITU se presentan con mayor frecuencia en el género femenino 86,5%. El grupo etario con más afección es la edad adulta 50,4%. El agente etiológico con mayor incidencia fue Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. La producción de BLEE como mecanismo de resistencia predominaron en las cepas de E.coli y Klebsiella spp. Se encontró un mayor porcentaje de resistencia para Ampicilina y SXT. Los antibióticos con mejor sensibilidad destacaron nitrofurantoína, fosfomicina. Conclusión: La especie con mayor aislamiento, implicada en la etiología de infecciones urinarias sigue siendo E.coli con una sensibilidad alta para nitrofurantoína y fosfomicina.

Urinary tract infections are considered a health problem at hospital and community level due to the increase of antibiotic resistant bacteria. Objective: To analyze the pattern of susceptibility and antimicrobial resistance of Enterobacteriaceae causing urinary tract infection. Methods: A descriptive research of documentary design was applied. The population was 672 records of positive urine cultures, collected from the San Pablo Laboratory database in the period 2021-2022. For tabulation and analysis, the data obtained were processed in SPSS software version 25.0. Results: UTIs occur more frequently in females 86.5%. The age group with the highest incidence was adulthood 50.4%. The etiological agent with the highest incidence was Escherichia coli 75.74%, Citrobacter Freundii 8.93%, Klebsiella spp 6.10%. The production of BLEE as a mechanism of resistance predominated in the strains of E.coli and Klebsiella spp. A higher percentage of resistance was found for Ampicillin and SXT. The antibiotics with the best sensitivity were nitrofurantoin and fosfomycin. Conclusion: The species with the highest isolation, implicated in the etiology of urinary tract infections, continues to be E.coli with a high sensitivity to nitrofurantoin and fosfomycin.

As infecções do trato urinário são consideradas um problema de saúde a nível hospitalar e comunitário devido ao aumento de bactérias resistentes aos antibióticos. Objetivo: Analisar o padrão de suscetibilidade e resistência antimicrobiana das Enterobacteriaceae causadoras de infecções do trato urinário. Métodos: Foi aplicada uma metodologia de investigação documental descritiva. A população foi de 672 registros de culturas de urina positivas, coletados do banco de dados do Laboratório San Pablo no período de 2021-2022. Para tabulação e análise, os dados obtidos foram processados no software SPSS versão 25.0 Resultados: As ITUs ocorreram com maior frequência no sexo feminino 86,5%. A faixa etária com maior incidência foi a adulta 50,4%. O agente etiológico com maior incidência foi a Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. A produção de BLEE como mecanismo de resistência predominou em E. coli e Klebsiella spp. Foi encontrada uma maior percentagem de resistência para a ampicilina e o SXT. Os antibióticos com melhor sensibilidade foram a nitrofurantoína e a fosfomicina. Conclusão: A espécie com maior isolamento, implicada na etiologia das infecções do trato urinário, continua a ser a E. coli com uma elevada sensibilidade à nitrofurantoína e à fosfomicina.

Evaluation of clinical and microbiological factors related to mortality in patients with Gram-negative bacterial infections treated with ceftazidime-avibactam: A prospective multicentric cohort study.

OBJECTIVES: This study aimed to evaluate the clinical and microbiological risk factors associated with mortality in patients treated with ceftazidime-avibactam for carbapenem-resistant Gram-negative bacterial infections. METHODS: This multicentric prospective cohort study included hospitalized adult patients with a microbiologically confirmed infection treated with ceftazidime-avibactam for ≥48 hours. The clinical and microbiological risk factors for 30-day mortality were evaluated using a Cox regression model. RESULTS: Of the 193 patients evaluated from the five tertiary hospitals, 127 were included in the study. Thirty-five patients (27.6%) died within 30 days. Infections with AmpC beta-lactamase-carrying bacteria were independently related to 30-day mortality (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.28-4.84, P < 0.01) after adjusting for time from infection to antimicrobial prescription (P = 0.04). Further, these bacterial infections were also related to higher in-hospital mortality (aHR 2.17, 95% CI 1.24-3.78, P < 0.01). Only one patient developed resistance to ceftazidime-avibactam during treatment. CONCLUSIONS: Treatment with ceftazidime-avibactam had worse clinical outcomes in patients with infections with bacteria with chromosomally encoded AmpC beta-lactamase. However, these findings should be confirmed in future studies.

A Study of Resistome in Mexican Chili Powder as a Public Health Risk Factor.

Chili powder is an important condiment around the world. However, according to various reports, the presence of pathogenic microorganisms could present a public health risk factor during its consumption. Therefore, microbiological quality assessment is required to understand key microbial functional traits, such as antibiotic resistance genes (ARGs). In this study, metagenomic next-generation sequencing (mNGS) and bioinformatics analysis were used to characterize the comprehensive profiles of the bacterial community and antibiotic resistance genes (ARGs) in 15 chili powder samples from different regions of Mexico. The initial bacterial load showed aerobic mesophilic bacteria (AMB) ranging between 6 × 103 and 7 × 108 CFU/g, sporulated mesophilic bacteria (SMB) from 4.3 × 103 to 2 × 109 CFU/g, and enterobacteria (En) from <100 to 2.3 × 106 CFU/g. The most representative families in the samples were Bacillaceae and Enterobacteriaceae, in which 18 potential pathogen-associated species were detected. In total, the resistome profile in the chili powder contained 68 unique genes, which conferred antibiotic resistance distributed in 13 different classes. Among the main classes of antibiotic resistance genes with a high abundance in almost all the samples were those related to multidrug, tetracycline, beta-lactam, aminoglycoside, and phenicol resistance. Our findings reveal the utility of mNGS in elucidating microbiological quality in chili powder to reduce the public health risks and the spread of potential pathogens with antibiotic resistance mechanisms.

Antibiotic resistance in wildlife from Antarctic Peninsula.

Although considered one of the most pristine ecosystems, Antarctica has been largely influenced by human activities during the last 50 years, affecting its unique biodiversity. One of the major global threats to health is the emergence of antibiotic-resistant bacteria that may be actively transferred to wildlife. We cultured and tested for antibiotic resistance in 137 cloacal and fresh fecal samples of several avian and marine mammal species from the Antarctic Peninsula, the most impacted area in Antarctica. Alarmingly, 80 % of the isolates showed antibiotic resistance, either phenotypically or genotypically. Most of the resistant bacteria, such as Enterobacteriaceae and Enterococcus species, are part of local gastrointestinal microbiota. Penguins and pinnipeds harbored a great diversity of antibiotic resistance and must be eligible as sentinels for future studies. These results show that antibiotic resistance has rapidly transferred to bacteria in Antarctic wildlife, which is a global matter of concern.

Detecção da secreção da toxina Sat pela Escherichia coli extraintestinal (EC071) na infecção de células endoteliais in vitro

Escherichia coli é uma bactéria gram-negativa da família das Enterobacteriaceae, inicialmente descrita como uma bactéria comensal, mas que pela aquisição de fatores de virulência tornar-se patogênica. Dentre os fatores de virulência importantes na patogenicidade destacam-se membros da família das Serino-proteases Autotransportadoras de Enterobacteriaceae. (SPATEs). Sat (toxina autotransportadora secretada) tem se destacado como fator de virulência presente nas E. coli patogênicas, sendo a SPATE mais prevalente em E. coli isolada de sepse. No entanto, até o momento, não está claro se Sat poderia conferir alguma vantagem no escape da E. coli do intestino e/ou na sua colonização e manutenção da bactéria em nichos extraintestinais, tais como circulação sanguínea, acarretando a bacteremia que, dependendo das condições do hospedeiro, pode vir a evoluir para um quadro grave de sepse. Desta forma, o objetivo deste trabalho foi investigar se uma cepa de E. coli extraintestinal, portadora do gene sat, isolada de bacteremia (EC071) secreta a toxina durante a infecção de células endoteliais, in vitro. Inicialmente as condições ideais para o cultivo bacteriano e estabelecimento do MOI foram determinadas. Em seguida, células endoteliais da linhagem HUVEC foram infectadas com a cepa EC071. Na análise da cinética de infecção, por Western blotting detectou-se a presença de Sat no sobrenadante das células a partir de 4h de infecção. Contudo, nos ensaios preliminares para avaliação da citotoxicidade que avaliou morfologia e destacamento celular a partir da comparação com células infectadas com a cepa HB101, utilizada como controle, os danos celulares observados não foram significativos. Desta forma, o esclarecimento sobre a ação de Sat sobre o endotélio e manutenção da bactéria dentro do contexto da infecção na corrente sanguínea, dependerá de novos ensaios.

Estudo microbiológico da ostra invasora Saccostrea cucullata: variação sazonal de coliformes totais e termotolerantes no Complexo Estuarino de Cananéia durante a temporada de 2018-2019 / Microbiological study of the invasive oyster Saccostrea cucullata: seasonal variation of total and thermotolerant coliforms in the Cananéia Estuarine Complex during the 2018-2019 season

No complexo estuarino lagunar de Cananéia, estado de São Paulo, região sudeste, há o consumo in natura da ostra invasora Saccostrea cucullata, principalmente no verão, alta temporada. Trata-se de um molusco filtrador que apresenta riscos de graves patologias do sistema gastrointestinal devido ao risco de armazenamento de agentes microbiológicos que afetam o ser humano. A falta de monitoramento, boas práticas de fabricação, qualidade da água e medidas de controle para garantir a segurança e qualidade do consumo de ostras é necessária para a prevenção de patógenos na saúde pública. Este estudo realizou análises microbiológicas de amostras de ostras, com foco em bactérias mesófilas, bactérias psicrotróficas e fungos/leveduras. Além disso, investigou-se as concentrações sazonais de coliformes totais e termotolerantes em amostras de ostras coletadas ao longo de um ano. As contagens de bactérias mesófilas nas ostras variaram de 1,45±0,22 a 3,32±0,28 log UFC g­1, com valores médios de 2,24±0,86 log UFC g­1. Para bactérias psicrotróficas nas amostras de ostras variou entre 1,34±0,29 e 3,12±0,45 log UFC g­1. Os dados revelaram que as contagens de fungos e leveduras variaram de 2,65±0,23 a 3,57±0,22 log UFC g­1. A contagem máxima de S. aureus foi de 1,24 log UFC g­1, e 83,5% das amostras apresentaram resultado negativo para este microrganismo. Não foi detectada presença de Salmonella spp. nas amostras analisadas. Esses resultados fornecem insights importantes sobre a variação sazonal e as contagens microbiológicas em amostras de ostras, destacando a relevância da monitorização e controle microbiológico em produtos alimentícios marinhos.

In the estuarine lagoon complex of Cananéia, state of São Paulo, southeast region, there is fresh consumption of the invasive oyster Saccostrea cucullata, mainly in summer, high season. It is a filter-feeding mollusk that presents a risk of serious pathologies of the gastrointestinal system due to the risk of storing microbiological agents that affect humans. The lack of monitoring, good manufacturing practices, water quality and control measures to ensure the safety and quality of oyster consumption is necessary for the prevention of pathogens in public health. This study carried out microbiological analyzes of oyster samples, focusing on mesophilic bacteria, psychrotrophic bacteria and fungi/yeasts. Furthermore, seasonal concentrations of total and thermotolerant coliforms were investigated in oyster samples collected over a year. Counts of mesophilic bacteria in oysters ranged from 1.45±0.22 to 3.32±0.28 log CFU g­1, with average values of 2.24±0.86 log CFU g­1. For psychrotrophic bacteria in oyster samples it ranged between 1.34±0.29 and 3.12±0.45 log CFU g­1. The data revealed that fungal and yeast counts ranged from 2.65±0.23 to 3.57±0.22 log CFU g­1. The maximum S. aureus count was 1.24 log CFU g­1, and 83.5% of the samples tested negative for this microorganism. No presence of Salmonella spp. was detected in the analyzed data. These results provide important insights into seasonal variation and microbiological counts in oyster samples, highlighting the relevance of microbiological monitoring and control in marine food products.

Evolución de la resistencia a los antibióticos de los microorganismos aislados de pie diabético infectado

Objetivos: evaluar la evolución de la resistencia a los antibióticos de los microorganismos aislados de pie diabético infectado en pacientes atendidos en el Hospital Clínico Viedma, en las gestiones 2014, 2016, 2018 y 2021. Métodos: investigación observacional, descriptiva, retrospectiva, transversal con enfoque cuantitativo, 268 cultivos y antibiogramas de pacientes con diagnóstico de infección de pie diabético fue la muestra analizada con un 2,82 % de error máximo admitido. Resultados: se identificaron 312 microorganismos, con 71,5 % las bacterias Gram negativas fueron las más frecuentes, de estas la Klebsiella spp con 17,9 % y Escherichia coli con 17,6 % predominaron, cuya resistencia a la ciprofloxacina, sulfatrimetoprim y gentamicina aumentó, los bacilos Gram negativos no fermentadores más aislados fueron las Pseudomonas spp y el Acinetobacter spp cuya resistencia a las cefalosporinas, ciprofloxacina y carbapenémicos incrementó. Por otro lado, con 16,3 % el Staphylococcus aureus fue la bacteria Gram positiva más identificada, la resistencia a la meticilina de 17 % en 2014 aumentó a 25 % en 2021. Conclusiones: las enterobacterias fueron los microorganismos aislados con más frecuencia, cuya resistencia se asoció a la producción de betalactamasas de espectro extendido (BLEE).

Objectives: to evaluate the evolution of antibiotic resistance of microorganisms isolated from infected diabetic foot in patients treated at the Viedma Clinical Hospital, in the 2014, 2016, 2018 and 2021 administrations Methods: observational, descriptive, retrospective, cross-sectional research with a quantitative approach, 268 cultures and antibiograms of patients with a diagnosis of diabetic foot infection were the sample analyzec with a 2,82 % maximum admitted error. Results: 312 microorganisms were identified, with 71,5% Gram- negative bacteria were the most frequent, of these Klebsiella spp with 17,9 % and Escherichia coli with 17,6% predominated, whose resistance to ciprofloxacin, sulfa trimethoprim and gentamicin increased, the most isolated non-fermenting Gram negative bacilli were Pseudomonas spp and Acinetobacter spp whose resistance to cephalosporins, ciprofloxacin and carbapenems increased. On the other hand, with 16,3 % Staphylococcus aureus was the most identified Gram-positive bacteria, methicillin resistance from 17 % in 2014 increased to 25 % in 2021. Conclusions: enterobacteriaceae were the most frequently isolated microorganisms, whose resistance was associated with the production of extended spectrum beta-lactamases (ESBL).

EVOLUCIÓN DE LAS COLONIZACIONES E INFECCIONES POR BACTERIAS PRODUCTORAS DE CARBAPENEMASAS EN UN HOSPITAL PEDIÁTRICO / EVOLUTION OF COLONIZATIONS AND INFECTIONS BY BACTERIA PRODUCERS OF CARBAPENEMASSES IN A HOSPITAL PEDIATRIC

La emergencia de bacterias productoras de carbapenemasas (BPC) representa un problema de salud pública. La vigilancia epidemiológica constituye una herramienta fundamental para el control de la diseminación

The emergence of carbapenemase-producing bacteria (PCBs) represents a public health problem. Epidemiological surveillance constitutes a fundamental tool for the control of dissemination

Genomic Insights into Pluralibacter gergoviae Sheds Light on Emergence of a Multidrug-Resistant Species Circulating between Clinical and Environmental Settings.

Pluralibacter gergoviae is a member of the Enterobacteriaceae family that has been reported sporadically. Although P. gergoviae strains exhibiting multidrug-resistant profiles have been identified an in-depth genomic analysis focusing on antimicrobial resistance (AMR) has been lacking, and was therefore performed in this study. Forty-eight P. gergoviae strains, isolated from humans, animals, foods, and the environment during 1970-2023, were analyzed. A large number of single-nucleotide polymorphisms were found, indicating a highly diverse population. Whilst P. gergoviae strains were found to be circulating at the One Health interface, only human and environmental strains exhibited multidrug resistance genotypes. Sixty-one different antimicrobial resistance genes (ARGs) were identified, highlighting genes encoding mobile colistin resistance, carbapenemases, and extended-spectrum ß-lactamases. Worryingly, the co-occurrence of mcr-9.1, blaKPC-2, blaCTX-M-9, and blaSHV-12, as well as mcr-10.1, blaNDM-5, and blaSHV-7, was detected. Plasmid sequences were identified as carrying clinically important ARGs, evidencing IncX3 plasmids harboring blaKPC-2, blaNDM-5, or blaSHV-12 genes. Virulence genotyping underlined P. gergoviae as being a low-virulence species. In this regard, P. gergoviae is emerging as a new multidrug-resistant species belonging to the Enterobacteriaceae family. Therefore, continuous epidemiological genomic surveillance of P. gergoviae is required.

Volatile Organic Compounds Produced by Kosakonia cowanii Cp1 Isolated from the Seeds of Capsicum pubescens R & P Possess Antifungal Activity.

The Kosakonia cowanii Cp1 strain was isolated from seeds of Capsicum pubescens R. & P. cultivated in Michoacan, Mexico. Genetic and ecological role analyses were conducted for better characterization. The results show that genome has a length of 4.7 Mbp with 56.22% G + C and an IncF plasmid of 128 Kbp with 52.51% G + C. Furthermore, pathogenicity test revealed nonpathogenic traits confirmed by the absence of specific virulence-related genes. Interestingly, when fungal inhibitory essays were carried out, the bacterial synthesis of volatile organic compounds (VOCs) with antifungal activity showed that Sclerotinia sp. and Rhizoctonia solani were inhibited by 87.45% and 77.24%, respectively. Meanwhile, Sclerotium rolfsii, Alternaria alternata, and Colletotrichum gloeosporioides demonstrated a mean radial growth inhibition of 52.79%, 40.82%, and 55.40%, respectively. The lowest inhibition was by Fusarium oxysporum, with 10.64%. The VOCs' characterization by headspace solid-phase microextraction combined with gas chromatography-mass spectrometry (HS-SPME-GC-MS) revealed 65 potential compounds. Some of the compounds identified with high relative abundance were ketones (22.47%), represented by 2-butanone, 3-hydroxy (13.52%), and alcohols (23.5%), represented by ethanol (5.56%) and 1-butanol-3-methyl (4.83%). Our findings revealed, for the first time, that K. cowanii Cp1 associated with C. pubescens seeds possesses potential traits indicating that it could serve as an effective biocontrol.